ICM 1984 - Awakening Australian midwifery

The story of the International Confederation of Midwives (ICM) Congress held in Sydney in 1984 is not simply another story of an important international conference and an ICM Council meeting.

It is a story of visionary midwifery leadership, risk taking, and the achievements that come from a focused collective effort, all within an Australian ethos of ‘having a go’.

It is a story of midwives sharing knowledge with international colleagues in ways that led to initiatives that continue to have an impact on Australian women and midwives to this very day.

Most importantly, it is a story of the awakening of midwifery as a separate profession from nursing in Australia.

Some of the key achievements, I think… ah… looking back, the early Eighties. We hosted, in Sydney, we hosted the International Confederation of Midwives. 1984… what  time that was!  We filled the Town Hall. We had midwives, of course, from all over the world. We… Australian midwifery was on show. Our Association, our national body, was only just coming together and we were a handful of people that were part of the organising committee.

It was just a very proud moment to be at the Opera House at the opening ceremony, and all of those wonderful early, the founders of the College, having worked so hard to get the College – to get the the Conference to Sydney… so that put us on the map!

Pat Brodie Hear more from the interview with Professor Pat Brodie here…

Two months after forming the National Midwives Association, Margaret Peters (Inaugural President NMA), Pam Hayes (Inaugural Vice President NMA), and Jenifer Cooling (Inaugural Secretary/Treasurer NMA) attended the 18th ICM Congress in Jerusalem. There they met up with Lesley Barclay. Lesley had been selected by the Royal Australian Nursing Federation as the Australian delegate, without the knowledge of the National Midwives Association.

They were all inspired, and their thoughts turned to Australia bidding for a future ICM Congress.

This was extraordinarily bold thinking given the National Midwives Association was barely a few months old and simply a National Committee under the  Royal Australian Nursing Federation (the national nursing organisation); there were no funds; no office; and no administrative support.

Nevertheless, over the next two years the National Midwives Association prepared Australia’s bid to host the 20th ICM Congress in 1984 in Sydney. With the support of the City of Sydney, the Lord Mayor and the Sydney Visitors Bureau, the bid was submitted in 1981.

At the 19th ICM Congress in Brighton UK in 1981, Margaret Peters and Pam Hayes were Australia’s delegates. Margaret spoke in support of the bid, although neither she nor Pam really expected it to be successful. Concern was expressed about Australia’s ability to hold an International Congress.  The National Midwifery Association Australia was still very new – barely three years old – and not all Australian States and Territories even had a midwives’ association as yet. The ICM had been formed in 1922 in Europe, and much of their early work and focus was in the Northern Hemisphere. And, Australia was on the other side of the world! There was doubt whether many would make the long trip to attend.

Given these concerns, bids were called for from the floor. This was most unusual, and outside of the normal process.

But there were no other bids forthcoming.

With no alternative bids on offer, Australia’s bid was declared successful.

Some European members remained very sceptical that it had any chance of being a success. Little did they know how wrong they would be proven to be!

Lesley Barclay: The 1981 ICM meeting in Brighton UK was another formative occasion.  I had submitted an abstract that was accepted. Somehow, I met up with Pam Hayes, who was a delegate there with Margaret Peters. Pam and I shared a hotel room with lots of laughs and memories that I will never forget and always treasure. It was here that we nominated to have ICM in Australia. We were successful and three years of extraordinarily hard work ensued. My memory is that Margaret did virtually all of the hard work in the committees.

Pat Brodie: That sounds like a milestone and a massive project for so few of you?

Lesley: Absolutely. A small group of Australian midwives hosting the International Confederation of Midwives Congress in Sydney in 1984 was certainly a milestone for the midwifery profession in this country. I was the secretary of the national organising group as well as representing the ACT. Pam Hayes represented NSW; Margaret Peters, Victoria; and Jenny Cooling, South Australia. Judy Davis was also at these meetings; she was getting WA up and running at the time.

Margaret paid a leading role in the business side of the meetings. This was such hard work for a small executive plus a couple of Sydneysiders (some of whom are no longer with us) who worked extraordinarily hard to make this happen so wonderfully well.

The ICM Congress laid out a clear picture of the work to be done if Australian midwives were to aspire to become equals with midwives from all around the world, with midwifery recognised as a profession in its own right – separate from nursing. We were small in number but we had the energetic leadership of Margaret Peters and Pam Hayes, which meant that we hosted a hugely successful conference, which is still talked about today, and which put us on the map globally.

Pat Brodie interviews Lesley Barclay. Read more from Lesley’s talk with Pat here…

Returning home, the Australians were jubilant and the news spread quickly. Australia’s first ICM Congress was to be the first held in the Asia-Pacific region, and only the second in the Southern Hemisphere (the first had been held in 1969 in Santiago, Chile).

Australia would have less than three years to organise everything, less than half the time normally offered to host countries to prepare.

It was then disclosed by the ICM that the Brighton Congress in 1981 (where we made our successful bid) had been run at a substantial loss. The Royal College of Midwives U.K. had to cover this loss, and no funds had come to ICM. It also became apparent that ICM had not received agreed funds from some other previous ICM Congress, which contributed to their poor financial situation. The ICM was in significant financial difficulty and could not assist with funding.

With no international or national funding available, no office or staff, a little over 300 members and less than three years to pull off an international event, the work ahead must have seemed overwhelming.

Midwives across Australia, whilst perhaps somewhat naïve, were focused, determined, well led, and prepared to take on the risk and responsibility, working together to make it happen.

Three committees were formed with the Sydney Congress Organising Committee having oversight and final say on everything. The Executive of this committee were Margaret Peters (Chairperson, Vic), Pam Hayes (Treasurer, NSW), and Deidre Siddall (Secretary, NSW); these key people were also members of the sub-committees.

The theme of the Congress was to be Midwives, Families, Nations and the World, with specific daily themes.

Sydney Opera House, 1984

The choice of the Sydney Opera House for the Opening Ceremony indicated that the committee was aiming high in showcasing Australian midwifery and Australia.

The scientific program was to be held in the iconic Sydney Town Hall and the new Hilton Hotel, just a 5-minute walk away.

For previous ICM Congress it had been the practice to have a written agreement detailing the financial arrangements, along with the split of any profits. In the current circumstances, no written agreement was made. The Organising Committee decided to honour past agreements anyway, and pay ICM a $15 capitation fee per registrant. The Australian mindset was such that this Congress was going to be a success, and making a loss was not an option. They started to raise the necessary funds – estimated to be somewhere between $300,000 and $500,000 (the equivalent of $1.1 to 1.8 million AUD today).

This set of overhead projector slides, handwritten by Pam Hayes, documents the dire financial circumstances going into ICM, the extent of planning required, and demonstrates the overwhelming task ahead. It also captures just how organised, methodical, and meticulous the NMA were in approaching the task, and their tremendous capacity to tackle the project head on. Australian midwifery was in very skilled and safe hands indeed.

Whilst midwives across the country shared the commitment of making the Congress a success, the NSW Midwives Association, the Sydney Congress Organising committees, and especially the Executive, carried the lion’s share of the workload. This was a time before mobile phones and e-mail; communication was by expensive ‘STD’ long-distance phone calls, ‘snail mail’, and face to face meetings. In that environment, with a small membership and a geographically large country that was new to international midwifery (and of course, these women were all working midwives too!), the collective effort was absolutely remarkable.

Fundraising was happening in all corners of the country and took every form imaginable. Funds and assistance came from various sources and in many forms, including donations from individuals and organisations.

State and Territory Midwives Associations and Nurses Boards funded local scholarships and some provided significant funds; and support came from a number of companies in the form of trade displays and sponsorships. The government organisation ‘Australian Aid’ sponsored midwives from the Pacific region and Africa to attend.

When designing the Congress logo, we took as our symbol the caring hands of the midwife. These hands we broadly arranged in the shape of Australia, and over these hands we lay the Southern Cross, a constellation which has a history dating back to the Aboriginal Dreamtime. It is said to have led the early explorers to discover the continent and laster was adopted to form part of out Australian Flag. The logo we coloured green and gold, traditional colours we use at international events such as this.

Pam Hayes

Birth in the land down under, ICM 1984

Western Australia compiled a booklet for the Congress A History of Midwifery Practice in Australia and the Western Pacific. A call went out for contributions, resulting in responses from each state and territory as well as Japan and Hong Kong.

Margaret Peters recalled an unexpected happening early on the first morning, when she was called to the Registration desk:

There were several midwives from Iran who were standing there holding bags of Pistachio nuts they had bought with them. They asked if they could pay their registration fees with the nuts. They were desperate to attend the education sessions coming from a country where midwives were undervalued and underpaid.

Margaret Peters (Chairperson and the then ICM President)

Margaret remembers those midwives did attend some sessions, but she could not remember how it was all resolved – nor how the nuts got into Australia through customs, or in fact what happened to them. Eaten perhaps!

The scientific program presentations provided the core of each day. Spread over the five days, the scientific program was scheduled to also enable meetings of the ICM Council and Regional Councils, and a choice of tours and professional visits across the week.

On the first morning Dr Angela Petro-Barvasian from the World Health Organization (WHO) was the keynote speaker. It had been a coup to secure her, and indicated the importance WHO gave to ICM Congresses. Her presentation The Status of Maternal and Child Health Today included a sobering look at the outcomes for women and their babies, particularly in developing countries.

The plenary sessions were held in the Sydney Town Hall in the mornings.

Plenary session © Pat Brodie 1984

Concurrent sessions were held in the afternoon, both in the Town Hall and in the Hilton Hotel. Each day, four of the five key note speakers were Australian midwives. Each presentation was wonderful and showcased different aspects of Australian midwifery. Later each day posters were presented and a selection of short films were shown. On two of the afternoons there were workshops, one for independent midwifery practitioners and the other about changing practices in childbirth.

We had a delightful representative from WA, a Judith Davis. She was giving a paper in the Town Hall. We had these beautiful floral decorations and one of those on a big stand. And she’s just introducing her paper… And suddenly from the other side of the stage, there’s a bit of movement with one of the flowers. And then, it gradually fell and went over, and she stood there and looked, and she said “Well… What about that?” I was anxious about this paper and I asked my friends in Perth to send warm fuzzies to me at 9 o’clock. They’ve sent them to the wrong side of the stage”. [laughs] And the place went into hysterics… You know we just really had a great time. That was just wonderful sort of opening up, and she gave a brilliant paper but I mean that was just brilliant…

Pam Hayes Read more from Pam here…

In the evenings there were the planned social events. Relationships were established and developed, and networking happened at every opportunity. The social program included a formal President’s Dinner for invitees on the first evening; an optional seafood dinner at a harbourside restaurant on the second evening; the Congress dinner and ‘Bush Dance’ (included in the registration) for the third evening; and an optional harbour cruise on the fourth evening, prior to the final day.

We had some social occasions that just went off!  She organised another one where it was the President’s Dinner. They decided everyone would sing a national song or something and… there was one representative from Lebanon and one from Israel or something and they shook hands while everyone’s crying and… just wonderful! Gathering. Of camaraderie. Of hail-fellow-well-ment… It was just great…

Pam Hayes Read more from Pam here…

All the social events were great fun but the Bush Dance at the congress dinner was a stand out – see the program here!

The Sydney Town Hall was decorated with green and gold balloons reaching to the ceiling, with hay bales on the stage and gum leaves and gum nuts decorating the tables. A traditional bush band entertained and everyone sang along. Featherdale Wildlife Park brought along some Koalas, which many wanted to hold. Artist Pro Hart even made a appearance!

Pro Hart…

Then came a shearing demonstration the likes of which, we suspect, the Sydney Town Hall had not seen before nor since! Dancers in colonial dress performed before everyone let their hair down and danced late into the night. No-one wanted to go home. Those who were there still talk about it today, recalling a brilliant evening with great music, wonderful company, plenty of food and drink, and demonstrations of all things Australian!

I found the Congress well worth attending. It broadened my outlook, informed me of new ideas and gave me greater confidence in myself and my profession. Midwives are moving forward in their care of themselves, families, and nations of the world.

The three year pregnancy and labour proceeded, the baby was delivered, and with great success.

Thank you midwives of the  world.

Congratulations to the Australian organising committee for the hard work.

…I would encourage those that are interested to work towards doing to the Netherlands in 1987. I am going to Japan in 1990.

D. Beyers, Nursery Charge Sister at Hornsby & Ku-ring-gai Hospital, Report to NSW Nurses Registration Board

And so, we had this conference that we worked our guts out to make financial. I was the Treasurer… There we were. We really were careful with every penny we spent and I was a little bit dictatorial about it. As to, you know, people get a satchel and they get some inclusions and what we put it in, and whether we could afford it, and where we got some money and those sorts of things.

Victoria were exceptionally careful that the quality of the (scientific) papers were good. Lots of European, Americans have rellies out here so it was quite good to come out. We had 1,500 people attend the conference.

It was a financial success. All the states had been gathering contingency funds. Didn’t have to give them because we had money. We were able to give the international body far more than we were liable for. The money that was over, it took a while, but we were able to set up a scholarship fund. The money in the contingency fund in the state, New South Wales, set up a scholarship fund there.

The people… that were there still talk about it. We had lots of goodwill and… don’t ask me any of the papers!

Pam Hayes Read more from Pam here…

The Congress Organising Committee met for the last time to review and finalise everything – a comprehensive summary was provided by Lesley Barclay in the NMA Newsletter of 20-21 October 1984.

In summary:

• The final attendance was over what had been estimated;
• The scientific program was uplifting, eye opening, and undergoing a formal evaluation;
• Everyone agreed the social program was a raging success; and
• There was recognition that the Sydney ICM Congress had raised government and public awareness of the important role of the midwife in improving the health and wellbeing of childbearing women and their babies

The initial costings were proven to be accurate and were $355,163 AUD (equivalent to $1.3 million AUD today).

The Congress made a profit of $114,433 AUD (equivalent to $418,575 AUD today).

The National Midwifery Association dispersed the profits by returning some provided funds to the state Midwives Associations, and $40,000 AUD (equivalent to $146,312 AUD today) was given to ICM – almost double what the Organising Committee had originally planned.

The remaining funds were used to create an Australian Midwifery Scholarship Fund (AMSF) by establishing an investment trust to provide ongoing scholarships for midwives.

All that was left was to say thank you for the hard work. The National Midwives Association spent no time resting. Lesley noted:

…We then suspended formal business to re-establish goals and priorities for the national body. It was important to get ourselves back on track after the Congress. A number of points were identified requiring thought and much hard work… The Executive have numerous jobs to do to get us off the ground again and pick up the threads of some very important tasks. Any euphoria or feelings of complacency that we achieved evaporated with the identification of those tasks. We will continue to need everyone’s support, tact, and intellect to move midwifery into the future.

Lesley Barclay NMA Newsletter 20-21 October 1984

The ICM Council meetings at this Sydney Congress saw the beginnings of broader international initiatives:

• Through Pam Hayes’ lobbying, the ICM Asia-Pacific Region, a vast area with very different midwifery organisations, became a region and met for the first time. It changed again in 2014, and Australia is now a member of the ICM Western Pacific Region;

• For the first time, the concept of an International Midwives Day was discussed with agreement to pursue creating it. Further discussions followed at the 21st ICM Congress in The Hague in 1987. It was finalised and announced at the 22nd ICM Congress in Kobe, Japan in 1990 and has been celebrated ever since (now called the International Day of the Midwife);

• The WHO ‘Safe Motherhood Initiative’ was discussed. Ongoing advocacy led to ICM becoming a formal partner with WHO, the International Federation of Gynaecology and Obstetrics (FIGO) and agencies of the United Nations (UN) in this initiative. This was launched by the UN at the Safe Motherhood Conference in Nairobi, Kenya, 1987;

• UNICEF undertook a favourable evaluation of the Congress, part of which was an assessment of the international standing and professionalism of ICM; and

• ICM financial difficulties were eased.

It is also worth considering what it must have meant to the still developing National Midwives Association to prove the doubters to be oh so wrong!  The NMA gained confidence, strength, power, prestige, autonomy, and the opportunity to begin to grow into their position as the National midwifery body we now know as the Australian College of Midwives. 

The ICM meeting was profoundly important, a milestone, for Australian midwifery. I think the activism to get ourselves away from the ANF as an independent organisation was really important. Many Australian midwives came to the conference, and even though we were not Incorporated with branches in each state, it acted as motivation for many of us to get our own branches up and running.

The modest financial profit from the conference laid down the foundations for the acquisition of the assets that the College has today, including the national office.

Pat: So that momentum from ICM inspired midwives to get involved in growing the profession here?

Lesley: Yes it did.

Pat Brodie interviews Lesley Barclay. Read more from Lesley’s talk with Pat here…

In 1984, some Australian midwives understood that the road to national midwifery professional recognition had begun in 1978 with the formation of the National Midwives Association (now the Australian College of Midwives), but most did not.

Many were aware of the important decision at the 1983 National Midwives Association 3rd National Conference to come out from under the umbrella of the nursing organisations and form a national midwifery organisation. But, still most did not.

With exposure to international midwifery, far greater numbers of Australian midwives gained confidence in themselves as midwives, their practice, and their midwifery profession.

They believed Australian midwifery should speak for and represent itself.

That realisation awakened Australian midwifery, and set us on the path to where we are now.

A major undertaking that challenged us all resulted from the vision, which emanated from New South Wales, of what the impact of hosting a major international event in this country would do for midwifery.

The management of the 20th Congress of the International Confederation of Midwives in 1984 was a tremendous commitment for an organisation that was struggling to increase its membership and financial base.

The thought that our international colleagues had sufficient faith in our ability to undertake this task could have been reassuring, if there had been any serious competition to our bid. Of further concern was the knowledge, once we came to hear of it, that the 19th Congress had incurred a considerable financial loss. The confederation, at the time, was in serious financial trouble and the only real prospect for securing the survival of that organisation rested with us.

Our membership then was less than five hundred. The personal and professional risks were considerable. That the Sydney Congress was a success, made a profit, gave Australian midwifery prominence internationally and nationally is now part of our history and that of the Confederation.

Although the risks were real, the commitment of Australian midwives was enormous and I for one shall forever carry with me the memory of the sense of ownership which prevailed among my colleagues before and during that week in Sydney. It was at the one time both inspiring and humbling.

Since then we have as an organisation, been active participants on the international scene, especially in the now titled Asia Pacific Region of the Confederation.

Many individual Australian midwives have established bonds with colleagues in less developed nations and are supporting them in their endeavours to improve maternal outcomes and the status of midwifery in their countries.

Another outcome of the Congress was the establishment with the profits, of the Australian Midwifery Scholarship Foundation to support midwives’ research projects, study tours, and to attend conferences. Provision was also made to financially support midwives from developing countries to expand their midwifery knowledge and skills in this country.

Margaret Peters

Read more from Margaret’s article here…

The majority of women in Australia today experience the benefits that come with advances in science and technology. But unlike women over a century ago, most do not experience the benefits that the continuity of relationship with a known midwife brings to their childbirth outcomes, experience, and their and their baby’s ongoing health. With higher expectations, further sub-specialisation of obstetrics, ongoing fragmentation of midwifery care, the explosion in intervention rates, the decreasing numbers of midwives and others still presuming to speak for midwifery, it is urgent to continue to increase our efforts to achieve midwifery professional recognition. This recognition in legislation, regulation and policy is essential to ensure that midwives now and, in the future, can work to their full scope of practice in the provision of midwifery care for women and their babies.

Most importantly, we need strong midwifery leadership in all aspects of midwifery practice, education and policy development.

Forty years ago, against all the odds, strong visionary midwifery leadership and the focused collective effort of Australian midwives saw the success of the Sydney ICM Congress. This was able to happen because of the prior formation of a national midwifery organisation that was not under the authority of nursing. Deep appreciation must go to the founders of our College for their vision, leadership, risk taking and hard work at a time when Australian midwifery desperately needed it. Those same qualities are again needed to realise the full potential of midwifery in Australia. Australian midwifery and the midwifery care and services midwives provide, depend on it.

ICM CONGRESS IN SYDNEY 1984: THE AWAKENING OF AUSTRALIAN MIDWIFERY

Article and website features prepared on behalf of the ACM Australian Midwifery History Project by Chris Cornwell PSM, BHA, Life Member ACM

Cornwell, C. (2024). ICM Congress in Sydney 1984: The awakening of Australian midwifery. Australian Midwifery News (Spring/Summer 2024), pp.56-59.

Chris’ original article was based on:

• Interviews, original documents and discussions with Margaret Peters OAM, ACM Founder and Distinguished Fellow, Life Member of UNICEF Australia
• Numerous original documents saved by Pam Hayes (dec) OAM, ACM Founder and Distinguished Fellow
• Advice and discussions with Jenifer Cooling, ACM Founder and Distinguished Fellow
• Advice and discussions with Lesley Barclay AO, ACM 2^nd Secretary and Distinguished Fellow
• Documents and discussions with a number of midwives who attended 1984 ICM in Sydney

Chris expresses her heartfelt thanks to Lorraine Doyle, Pamela Mulholland, Ann Grieve, and Marijke Eastaugh, who sorted through countless boxes and found original documents, and sincere thanks to members and advisors of the ACM Australian Midwifery History Committee for their advice and support.

In addition to Chris’ article, this webpage also contains additional resources:

• Photographs from the personal collection of Professor Patricia Brodie, AM, former ACM President and founding member of the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund
• Transcripts from interviews with Margaret Peters, Pamela Hayes, and Lesley Barclay, and a video interview extract with Pat Brodie
• Objects from the Pam Hayes Midwifery Archive Object Collection
• Thompson,J.E., Walker, J., Thomson, A.M., Peters, M.H. (2022). 100 years of History of the International Confederation of Midwives: Empowering midwives and empowering women. Brown Dog Books.